A qualitative study to develop materials educating patients about opioid use before and after total hip or total knee arthroplasty.

Autor:	Smith DH; Kaiser Permanente Center for Health Research, Portland, Oregon., Kuntz J; Kaiser Permanente Center for Health Research, Portland, Oregon., DeBar L; Kaiser Permanente Washington Health Research Institute, Seattle, Washington., Mesa J; Kaiser Permanente Center for Health Research, Portland, Oregon., Yang X; Kaiser Permanente Center for Health Research, Portland, Oregon., Boardman D; Northwest Permanente, Orthopaedic Surgery, Portland, Oregon., Schneider J; Kaiser Permanente Center for Health Research, Portland, Oregon.
Jazyk:	angličtina
Zdroj:	Journal of opioid management [J Opioid Manag] 2018 May/Jun; Vol. 14 (3), pp. 183-190.
DOI:	10.5055/jom.2018.0448
Abstrakt:	Objective: The authors undertook a qualitative study with open-ended, structured interviews to understand patient)s educational needs for patients undergoing total hip and total knee arthroplasty (THA/TKA). Design: Provider interviews explored their approach with THA/TKA patients on: pain management; barriers to opioid tapering; and recommendations/changes on educational materials to support pain management and opioid reduction. Patient interviews explored their experience, understanding, beliefs surrounding opioids, and recommendations on important content. A qualitative methodologist conducted interviews and content analysis to identify key themes. Setting: Kaiser Permanente Northwest, community setting. Patients, Participants: A purposeful sampling method identified interviewees (surgeons, advice nurses, physical therapists, physician assistants, and patients). Patients were recent THA/TKA cases in the top third of opioid use after surgery. Interventions: N/A. Main Outcome Measure(s): Qualitative study. Results: Recommendations for patient educational content included: (1) clear descriptions of how opioids work in the body, how to taper, nonopioid pain management options, and problems from overuse; (2) messaging on how long to expect to use opioids and type of pain to expect; (3) visual timeline to illustrate opioid tapering and exercise expectations; (4) emphasize that pain management is multimodal, and stress the balance between opioids for recovery versus overuse; (5) provide educational messaging multiple times prior to and after surgery. Conclusions: Patients and providers agreed that clearly stated verbal and written messaging is needed beyond what has typically been done regarding opioid expectations.
Databáze:	MEDLINE
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